MEDICARE: JAYLIN GOODLOE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1699579813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYLIN GOODLOE

Provider Business Mailing Address
First Line	:	2271 CLINTON ST UNIT 3306
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80010-1063
Country	:	US
Telephone Number	:	601-317-3955
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 E COLFAX AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-2212
Country	:	US
Telephone Number	:	601-317-3955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	04/04/2025

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Directions to “ JAYLIN GOODLOE ” Practice Location

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